Respiratory conditions: effect of housing and other factors.

Abstract

SUMMARY The public health movement has been concerned with the relation between housing and health for well over a century. Nevertheless the Black Report still identified housing as one of the major causes of ill-health and suggested, on one indicator at least, that council housing is the least healthy form of tenure. An exploratory study concerning housing and health in a north eastern local authority area is described. It was found that smoking, work experience, and age were the most important determinants of self assessed respiratory conditions. When the background factors were held constant people in areas of 'bad' housing were found to report more respiratory symptoms than those in 'good' housing areas. Respiratory conditions were affected by the age of housing, and flats were found to be worse than houses. High rise flats were worse than low or medium rise flats.The public health movement has shown a traditional concern with the relation between the health of the population and the housing in which they live. In his historical analysis of health in 19th century Britain, Wohl1 comments: "As the century progressed it became increasingly apparent that the growing structure of public health rested on domestic foundations and that the nation could not be healthy unless it housed its masses in healthy housing."This concern with the effect of housing on health progressed into the 20th century. Before the second world war a plethora of research demonstrated a causal connection between the dwellings in which people live and their state of health. In particular, tuberculosis was shown to be closely connected with over crowding and lack of basic amenities.2 At the time the housing market was dominated by the privately rented sector: in 1914 900/, of dwellings were rented from private landlords. Since then there has been a marked growth of public intervention in the housing market which, together with a large increase in owner occupation, reduced the privately rented sector to 12%/o of dwellings by 1982.3

Residential Moving and Preventable Hospitalizations

“…13 A number of researchers have suggested a link between the frequency of home moves and the development of respiratory conditions or infections. 15,36,37 Our findings reinforce previous work in illustrating that moving home frequently presents an increased risk of PPH for asthma and ear, nose, and throat infections. We also found that increased residential mobility resulted in an increased risk of PPH for convulsions and epilepsy, dehydration and gastroenteritis, and influenza/pneumonia.…”

Social position and mortality from respiratory diseases in males and females

“…Household crowding has been found to cause increased incidence of respiratory infections, but whether this is associated with development of COPD in adulthood is unsettled. In a British study, people in areas of bad housing were found to report more respiratory symptoms, and flats were found to be worse than houses [17]. A Danish study focusing on housing found that smoking-adjusted FEV1 was reduced by 10 mL?yr of living -1 without central heating [18].…”

Damp housing conditions and respiratory symptoms in primary school children

“…10 Poor-quality housing and dampness in particular are believed to cause respiratory ill health. 11,12 Allergic reactions to house dust mites [13][14][15] or airborne spores of molds [16][17][18] are plausible mechanisms for a causal relationship between damp housing conditions and respiratory symptoms. Associations among reported dampness, molds, and respiratory symptoms in children have been reported.…”